Review Of The Literature Research Proposal

Published: 2021-07-10 19:25:05
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Category: Brain, United States, America, Medicine, Health, Disease, Dementia, African American

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Abstract
In order to understand the effect of hemoglobin count or iron metabolism on Alzheimer’s disease is one of the purposes of this study. The other purpose is to see if these differences in the way iron is metabolized or the difference in hemoglobin count among ethnic groups effect the way they acquire Alzheimer’s over time. The most common effect of AD is dementia which is one of the most common effects of Alzheimer’s disease and tis is the loss of the ability to mentally process normal day to day activities. Dementia can last for a long time sometimes more than six months and may not be present since birth or a loss of consciousness. (medicaldictionary.com) .
The most common cause of dementia is Alzheimer’s disease (AD). Senile plaques, neurofibrillary tangles are two main abnormal structures that clog’s the brain of a person with Alzheimer’s disease or AD.). Twisted mass of nerve cells are called neurofibrillary tangles and neurons surrounding a group of protein called amyloidal deposits are called senile plaques. Comparison of the neuroimages of the two populations studied is taken into consideration. Specific neuroimaging of patients with Alzheimer disease of two groups: white and black patients might reveal differences in iron distribution and help target balancing iron distribution as main therapy. All racial and ethnic people are affected by Alzheimer's disease and dementia. When assessing services or information on AD there are problems encountered by communities of color and other historically underserved groups.
Caucasians and ethnic groups especially African American groups have different genetic risk factors. Alzheimers disease is prevalent in persons with high blood pressure or high cholesterol levels according to data from large scale longitudinal studies. Patients with both high blood pressure and cholesterol have found that dementia sets in four times more that others who had only one of the two African-Americans have a higher rate of vascular dementia than white Americans. Clinical trials, screening and assessment of these unique presentation of AD in African American population are not designed yet today. Research shows that there is a higher incidence, risk and prevalence of AD in African Americans when compared to non Hispanic whites. Vascular disease may be one of the factors contributing to this data.
Empiricial data and evidence shows that ethnic groups show differences in the onset of dementia and AD if they are living in the United States of America. Studies also show that people of African descent and Hispanics show a higher onset of dementia and Alzheimer’s when compared to those of European descent. Lowest rates are in Native American Indians and those of Asian descent comparable to the local white population .
Comparing rates of AD and or dementia among Hispanics and African Americans to whites many American studies have done just that. These studies found higher rates of cognitive impairment, dementia, and AD among ethnic minorities than among whites (Folstein.et.al)
Alzheimer’s disease was never part of normal aging process though it is not the largest risk factor for aging The American federation of aging research says that, “One in eight people 65 and older have Alzheimer’s. It was observed that approximately 6% of men over 65 and women between 65-74 years have been diagonised with AD. Another data showed that nearly half of those age 85 and older have the disease. It was also reported that a small percentage of individuals of suffering from AD where below the age of 65years and this was 2-7%. (www.afar.org//)
Toxins in the environment is thought to play an important role in the development of AD and this is evidenced from research and empirical evidence.
Therefore detoxification is vital to remove environmental toxins such as chemicals and metals,known to produce neurodegenreation. (http://www.evenbetterhealth.com/als-detoxification-therapy.php)
There was research evidence to show that African American people where prone to Alzheimer’s Disease when residing in the U.S when compared to their relatives in Africa. In Nigeria for example autopsies of brain tissue showed the absence of senile plaques that are typical of AD which could be because of environmental influence and diet. psychiatry.medicine.iu.edu/index.php/download file/view//712/
Method
Purpose
Paradigm
The high prevalence of Alzheimer disease in elderly African American living in the United States has recently caught the eye of the doctors and scientists alike. These findings are surprising as the same ethnic populations in their home land have had lesser incidents of AD comparatively. This goes on to suggest that there is more of an environmental influence to getting AD that heredity. Diet low in supplements and vital nutrients could be t he key factor in the development of this disease as suggested by recent research.
Study Design
The type of study is an ethnographic comparative study with a small sample (10) of African American individuals with clinical dementia whose brain autopsies where compared to an exact number (10) of Caucasian individuals with clinical dementia.
Population and Sample
20 persons matched for age, gender and clinical dementia rating, 10 of whom were of African American descent and 10 where of Caucasian descent. Samples taken where from brain autopsy which according to Wilkins (2006) showed the , “presence and degree of neurofibrilatory tangles, senile plaques, lewy bodies, cerebral infarcts, and cerebral amyloidal antipathy” (Wilkins, 2006).
Investigative Techniques
History of previous medical, family and social experiences, depression history was included in the assessment protocol. Information of the cognitive function of the participant, form a reliable relative, or spouse, .A psychometric battery of detailed examinations that involve semantic memory, working memory, episodic memory, mental control, psychomotor speed, language and visual function where the variable measured for each participant. Histories of medical conditions such as history of stroke, smoking, diabetes, and depression were obtained from each participant, through health history and with patient’s family permission and insurance their health records.
Data Collections
Neuropathology methods and data showed the following results:
- Regions of the left cerebral hemisphere where examined and sections where cut and stained.
- Microscopic sections from each region showed diffuse plaques that where amorphous or finely febrile deposits and lacked abnormal neuritis.
- Cortical leeway bodies notes present or absent after search through sections of entohinal cortex of the limbic system.
- Presence and degree of infarcts were determined in the white, gray and brainstem
- Hypertension was tested using the Fisher exact test was used to compare the two groups.
Results
Differences where not seen in either of the groups studied, that is Caucasian or the African American groups, in the incidences of heart stroke, smoking, apolipoprotien genotype, or performance on the cognitive tests. African American subjects reported a higher incidence of hypertension. None of the participants had diabetes.
Neuropatho logical diagnosis of Alzheimer’s disease was present in all the African American subjects when compared to their Caucasian counterparts.
A difference in brain weight was also seen in the African American subjects whose brain weighed lighter than their Caucasian counterparts.
There was no difference in other neuropath logical variable such as presence or number of infarcts, plaques, tangles and lewy bodies.
One other significant difference between the 2 groups was the presence of ambled antipathy in 33% of the African American group while there was no evidence in the Caucasian group.
Limitations
Since this was a very small study in terms of number of subjects used, it would need to be replicated in large numbers. There has also been conflicting results from other studies that compared vascular dementia between the two groups used in this study and found African American groups having more dementia and Caucasian subjects having more Alzheimer disease pathology. (De la Monte, et.al)
References
(n.d.). Cultural/ethnic diversity & alzheimer's, . Retrieved from http://www.alz.org/alzwa/in_my_community_13902.asp
Grant, W .(1997). Alzheimer’s Disease Review 2. Sanders-Brown Center on Aging, University of Kentucky 42-55, 1997 ,. Retrieved from http://www.coa.uky.edu/ADReview/.
Grant , W (1997) Dietary Links to Alzheimer’s disease
Manly, J and Mayeux, R . Ethnic Differences in Dementia and Alzheimer’s disease
Retrieved from http://www.nap.edu/openbook.php?record_id=11086&page=95
ALZHEIMER'S DISEASE - American Federation for Aging Research., Retrieved from
www.afar.org//130308

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